Bleeding Disorders: How Can They Impact My Pregnancy, And How Can PT Help?

Bleeding and clotting disorders affect many people in the United States and throughout the world. When someone has a bleeding disorder, their blood often clots too slowly, which can lead to complications throughout the body.

Pregnancy adds new considerations if you have already been diagnosed with a bleeding disorder. Staying in close contact with a physical therapist can help keep you safe and healthy during your pregnancy.

Pregnancy can be a magically confusing time, full of new changes and lots of questions. Some of the transformations your body experiences during pregnancy are well known – your belly gets bigger, your bladder may feel smaller, and you may feel little kicks deep in your pelvis. Some other changes are less visible, including changes to the hemostatic (bleeding) system. These changes happen to every pregnant parent, and it’s even more important to consider them if you currently have a bleeding disorder.

During pregnancy, your body uses multiple strategies to make your blood clot quickly and efficiently. The factors and proteins in the blood that help with clotting increase, while the other factors and proteins that inhibit clotting decrease. This helps decrease the likelihood of spontaneous bleeding and helps keep the baby safe. Patients with bleeding disorders, such as von Willebrand disease or hemophilia, have no higher risk of miscarriage, placental issues, or bleeding during pregnancy than people without a bleeding disorder. For people with bleeding disorders, these changes are protective, and you may notice fewer bleeding symptoms during this time, including fewer bruises, nosebleeds, and less bleeding when brushing your teeth or flossing.

As delivery draws closer, this pattern continues until the baby arrives. This protects the new parent from excessive bleeding during delivery. Still, your hematologist (a doctor who specializes in bleeding and may manage your bleeding disorder) and your obstetrician may take special precautions to keep you and the baby safe. Depending on the severity of your bleeding disorder and your personal history, this may include taking extra medication, having extra specialists at your birth, or opting for induction or a c-section.

With your body doing all it can to keep your pregnancy going smoothly and with extra care from your obstetrician and hematologist, adding a physical therapist can help you feel even better. Here are a few benefits of physical therapy for pregnant parents with bleeding disorders:

1. Establish yourself with a pelvic health physical therapist early in your pregnancy.

Come into your local Athletico for a free assessment or schedule a full evaluation with a pelvic health PT. Pelvic health therapists specialize in changes during pregnancy and can help prevent problems before they occur. By meeting with a PT early, you can learn about safe ways to stay active, prevent common pregnancy-related complaints, and address any concerns quickly before they become bigger problems.

2. Help your team work together during pregnancy and to prepare for delivery.

Communication is key! Your Athletico pelvic health PT can help explain any concerns you have to your obstetrician and hematologist and will also be eager for their input. You can sign a release to ensure everyone on your team can share the latest updates on your condition and progress so everyone (including you) can be on the same page. If you feel like you need an extra set of ears in the room, your Athletico PT may be able to accompany you to your doctors’ appointments, if you would like.

3. The best exercise is the one that is right for you!

Understanding the best way to exercise when you have a bleeding disorder can be complicated, and it may be even more confusing during pregnancy! Appropriate exercise during pregnancy can ease constipation, decrease back pain and much more. Most exercise is safe and beneficial for people with bleeding disorders. Discussing an exercise plan with a pelvic health PT can ensure you have the best exercise plan with special consideration for your pregnancy and your bleeding disorder.

This is your time to shine!

Pregnancy can be full of joys, smiles, and giggles as well as doubts, questions, and concerns. Pregnancy with a bleeding disorder doesn’t have to limit the good feelings or increase the tough ones. Information and education are key to helping you navigate this new season of your life with attention to your bleeding disorder but not be overwhelmed by it. Athletico’s pelvic health PTs are here to help you ease your uncertainties and be another member of your healthcare team.

Find a Pelvic Health Therapist Near You

*Per federal guidelines, beneficiaries of plans such as Medicare, Medicaid, Tricare, VHA and other federally funded plans are not eligible for free assessments.

The Athletico blog is an educational resource written by Athletico employees. Athletico bloggers are licensed professionals who abide by the code of ethics outlined by their respective professional associations. The content published in blog posts represents the opinion of the individual author based on their expertise and experience. The content provided in this blog is for informational purposes only, does not constitute medical advice and should not be relied on for making personal health decisions.

References:
1. “Articles about Bleeding Disorders in Women.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 23 June 2023, http://www.cdc.gov/ncbddd/blooddisorders/women/articles.html.
2. Bremme, Katarina A. “Haemostatic changes in pregnancy.” Best practice & research. Clinical haematology vol. 16,2 (2003): 153-68. doi:10.1016/s1521-6926(03)00021-5
3. “Exercise during Pregnancy.” ACOG, http://www.acog.org/womens-health/faqs/exercise-during-pregnancy. Accessed 20 Apr. 2024.
4. “MASAC Document 275 – MASAC Recommendations Regarding Physical Therapy Management for the Care of Persons with Bleeding Disorders: NBDF.” National Bleeding Disorders Foundation, http://www.hemophilia.org/healthcare-professionals/guidelines-on-care/masac-documents/masac-document-275-masac-recommendations-regarding-physical-therapy-management-for-the-care-of-persons-with-bleeding-disorders. Accessed 20 Apr. 2024.